A regulação do acesso ao parto: avaliando o caso do município do Recife

Childbirth must take place at the right time and place for a healthy birth. Faced with this prerogative, this dissertation evaluates the regulation of access to childbirth in the city of Recife, verifying the regulatory flows of care to the parturient. It is an evaluative research of the type of case study, with quantitative and qualitative approach; the combination of research methods and techniques was necessary in this case due to the magnitude and complexity of the topic addressed. It was necessary to carry out the mapping of the network of maternal and child care and construction of maps of dominant flows for health facilities of reference to childbirth, both of the usual risk and high risk of the municipality of Recife. In order to verify in depth the criteria addressed in the research, we carried out semi-structured interviews with puerperal women, health professionals and managers linked to the process of regulation and structuring of the health care network (Stork Network). The results show how the actual flow of users within the network occurred; in this case it was verified that these women do not follow the flow established for the references, which occurs for multiple causes, such as: lack of attachment of the pregnant woman to the health center where the delivery will take place, overcrowding of the hospitals and maternities or lack of knowledge about the establishment to be addressed at the time of delivery. This fragility of the health care network generates a pilgrimage of the pregnant woman in the antepartum and makes it difficult to receive them in the health services and conducts the good practices of attention to childbirth and birth. The way to systematize the regulation of access to childbirth in the city of Recife, does not guarantee the equal access to pregnant women, there is this flaw in the protective role of the State, causing a disorganization of the obstetric network that contributes to exposing mothers and babies to situations of vulnerability and suffering.